Authors: Basel Al Kadah George Papaspyrou Mathias Schneider Bernhard Schick
Publish Date: 2014/05/23
Volume: 272, Issue: 1, Pages: 117-122
Abstract
Hereditary haemorrhagic teleangiectasia HHT is most notably characterized by vulnerable vascular formations of the nasal superficial mucosa Epistaxis is one of the most common symptoms of the afflicted patients with an incidence of more than 90 A variable series of treatments have been described ranging from nasal ointments to the complete surgical occlusion of the nose The objective of this pilot study is the presentation of first experiences in treating patients suffering from HHT and chronically recurrent epistaxis with an individual nasal olive made from silicone Eleven patients six men five women aging from 44 to 80 years with known HHT were treated at the ENT department of Homburg/Saar between October 2008 and July 2012 because of nasal bleeding by NdYAG laser or argon plasma coagulation After the surgical treatment an imprint of the nasal aditus was taken to manufacture an individual custommade silicone nasal olive Patients were wearing the nasal olive for 3–8 h a day Checkups were made every 6 months Epistaxis severity score ESS was used pre and postnasal olive application The observation period was 12–48 months The utilization of the silicone nasal olive led to a distinct reduction of epistaxis events Apart from the nasal olive our patients needed no further treatment of the nose during the observation period except for a nasal ointment Insertion and removal of the nasal olive were handled by the patients themselves The local manipulation in handling the nasal olive caused no epistaxis itself A significant improvement of the ESS and satisfaction was reported in all patients Use of an individually manufactured silicone nasal olive is a promising extension to the established treatments of epistaxis in HHT patients Tolerance towards this treatment by the patients was high due to the low personal burden and encumbrance The extended use of the presented method in HHT patients may be beneficial However a more prolonged observation period is necessary in the future to judge the longterm efficiency of individual nasal olives
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